Provider Demographics
NPI:1477044790
Name:SOLIDARITUS HEALTH GROUP PC
Entity Type:Organization
Organization Name:SOLIDARITUS HEALTH GROUP PC
Other - Org Name:SOLIDARITUS FHC - TULSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:539-202-1585
Mailing Address - Street 1:1025 CONNECTICUT AVE NW STE 907
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5434
Mailing Address - Country:US
Mailing Address - Phone:202-256-4116
Mailing Address - Fax:
Practice Address - Street 1:4415 S HARVARD AVE STE 209
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2618
Practice Address - Country:US
Practice Address - Phone:202-256-4116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLIDARITUS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-22
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty